by Kendra Dahlstrom 10/18/07
Many women roll their eyes when someone mentions the words "birth plan". Isn't that
just something fanatic pregnant women do? That is precisely what I thought three years
ago. I was a newly married woman with no children. I had heard the words "birth plan"
thrown around a lot when I would talk to my pregnant friends, but none of them seemed
to think it was a necessary step to take to ensure a positive birth experience. At
the time, I agreed. Then I got pregnant and ended up having a cesarean with my first
daughter. It was then that I began my quest to prevent unnecessary cesareans in this
country. I knew my next child would be born via VBAC (Vaginal Birth After Cesarean),
and I wanted to do anything and everything to make sure that happened. After hearing
advice from fellow VBAC moms, I realized that making a birth plan was one of the best
ways to ensure a successful vaginal birth.
Fortunately, I went on to have a natural birth for my second daughter. I attribute
much of that success to my preparation and birth plan. I have laid out the steps to
take to create a useful birth plan that outlines your ideal experience.
Discuss Your Options
Before you know what you want your birth to be like, explore all the options available
to you. For example, some women like acupuncturists and massage therapists present
during their labor. Other women want gentle music and unlimited shower use. The options
are virtually endless. Ask other moms what was useful during their own labors. Ask
doctors and midwives what they have experienced. When you have a suitable list, sit
down and discuss with your partner what you would like to include in your birth plan.
State Your Goal
The first part of your birth plan should be a statement of your ultimate goal. For
some women this solely means a healthy baby. For other women it means a vaginal birth.
Others prefer a scheduled cesarean.
List Desirable Objects and People
Next, write down the people and things you would like present during labor. This can
be as simple as making a list. For instance: birthing ball, heating pad, breast pump,
husband, doula, and mother are all possible options. This list should include everything
that will make you feel more comfortable during labor.
Record Unwanted Procedures
Many people believe that birth plans are limited to your wishes during labor. However,
it is also the perfect place to clearly state what you would not like done.
For instance, some women do not want an episiotomy, their water broken, cervical checks,
or constant fetal monitoring. You must make it absolutely clear that this is your
labor and you have the ultimate decision over what happens to your body. I had it
listed in my birth plan that I did not want my water broken. Right away when I arrived
at the hospital to have my second daughter, the doctor began pressuring me to break
my water. The nurse, who had read my birth plan, stood up for me. Although I was in
pain, my birth plan was proof of my wishes.
List Pushing Positions
Pushing may be one of the shortest parts of labor, but it is also one of the most
important. The duration and positions of pushing can determine how successful your
vaginal birth will be. You must make it very clear what positions you would like to
try during your own labor. Some examples of pushing positions include: squatting,
kneeling, side lying, standing, or squatting in a chair. Don't settle for the old
back lying position if it is not what you want.
List Wishes After Birth
There are many things that happen after your baby is pushed out of your body. The
umbilical cord is cut and clamped, vitamin K injections are administered as well as
eye ointment, the afterbirth occurs, and the mother is re-stitched. Any and all of
these things can be omitted if it is your wish.
A birth plan is a legal document. Doctors, nurses, and hospitals cannot ignore a legal
document. Pregnancies and births are very personal. Don't let a doctor tell you how
you will experience labor and birth. Make your birth wishes known by creating a birth